Efficacy, safety and tolerability of linezolid containing regimens in treating MDR-TB and XDR-TB: systematic review and meta-analysis.

Details

Serval ID
serval:BIB_F5F7B9F1FC03
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Efficacy, safety and tolerability of linezolid containing regimens in treating MDR-TB and XDR-TB: systematic review and meta-analysis.
Journal
European Respiratory Journal
Author(s)
Sotgiu G., Centis R., D'Ambrosio L., Alffenaar J.W., Anger H.A., Caminero J.A., Castiglia P., De Lorenzo S., Ferrara G., Koh W.J., Schecter G.F., Shim T.S., Singla R., Skrahina A., Spanevello A., Udwadia Z.F., Villar M., Zampogna E., Zellweger J.P., Zumla A., Migliori G.B.
ISSN
1399-3003 (Electronic)
ISSN-L
0903-1936
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
40
Number
6
Pages
1430-1442
Language
english
Notes
Publication types: Journal Article
Abstract
Linezolid is used off-label to treat multidrug-resistant tuberculosis (MDR-TB) in absence of systematic evidence. We performed a systematic review and meta-analysis on efficacy, safety and tolerability of linezolid-containing regimes based on individual data analysis. 12 studies (11 countries from three continents) reporting complete information on safety, tolerability, efficacy of linezolid-containing regimes in treating MDR-TB cases were identified based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Meta-analysis was performed using the individual data of 121 patients with a definite treatment outcome (cure, completion, death or failure). Most MDR-TB cases achieved sputum smear (86 (92.5%) out of 93) and culture (100 (93.5%) out of 107) conversion after treatment with individualised regimens containing linezolid (median (inter-quartile range) times for smear and culture conversions were 43.5 (21-90) and 61 (29-119) days, respectively) and 99 (81.8%) out of 121 patients were successfully treated. No significant differences were detected in the subgroup efficacy analysis (daily linezolid dosage ≤600 mg versus >600 mg). Adverse events were observed in 63 (58.9%) out of 107 patients, of which 54 (68.4%) out of 79 were major adverse events that included anaemia (38.1%), peripheral neuropathy (47.1%), gastro-intestinal disorders (16.7%), optic neuritis (13.2%) and thrombocytopenia (11.8%). The proportion of adverse events was significantly higher when the linezolid daily dosage exceeded 600 mg. The study results suggest an excellent efficacy but also the necessity of caution in the prescription of linezolid.
Pubmed
Web of science
Open Access
Yes
Create date
03/01/2013 20:03
Last modification date
20/08/2019 17:22
Usage data